452 MATERIA MEDIC A AND THERAPEUTICS. 



Poisons may also be removed from the blood by simple increase 

 of the excretions carbonic acid through the lungs by artificial 

 respiration ; urea by diuresis, free purgation, and diaphoresis ; 

 and so with the products of indigestion, which is relieved by a 

 cathartic pill and a saline draught. 



If the htemoglobin be deficient, we must secure a sufficient 

 supply of digestible and nutritious food, pure air, and direct 

 sunlight ; reduce the amount of work, by ordering rest or even 

 confining the patient to bed; and attend to all the functions 

 which are connected with the f ormation, growth, and purifica- 

 tion of the blood. Correction of derangements of the stomach 

 and bowels always demands special attention, and is a sine 

 qua non for success. At the same time, any actual waste of the 

 blood must be arrested, if possible. Passive haemorrhages must 

 be checked. Growth and development may be rendered less 

 trying by directing the blood to parts where it is specially 

 required; for instance, to the uterus by means of emmena- 

 gogues. We must next hasten to restore the red corpuscles by 

 supplying their important chemical elements Iron, Phosphoric 

 Acid, and Potash. Long before the composition of haemoglobin 

 was understood, it had been empirically discovered that Iron 

 was a certain remedy for " want of blood." This is our daily 

 experience still ; science in this instance has confirmed and not 

 suggested practice. Iron has other actions and uses thera- 

 peutically, but its chief employment is as a haematinic. The 

 particular form in which the metal may be administered is 

 discussed under its own head, but one or two combinations 

 with iron must be noticed here. The Mistura Ferri Com- 

 posita, an old-established empirical combination of Proto- 

 sulphate of Iron, Carbonate of Potash, Myrrh, and Aromatics ; 

 the Pilula Ferri et Aloes ; and the non-officinal pill of Blaud, 

 containing Protosulphate of Iron and Carbonate of Potash, 

 are specially successful remedies in anaemia, the rationale of 

 which will now be obvious to the student. The Phosphate 

 of Iron is also indicated, and is highly successful in some 

 instances. Altogether, the medicinal treatment of deficiency 

 of haemoglobin practically resolves itself into the continuous 

 administration of iron in some useful form or combination, 

 without impairing digestion or the action of the bowels. 



In urgent cases of want of blood corpuscles, whether acutely 

 developed by hfcmotrhnge, or progressing slowly to an extreme 

 degree, transfusion must be practised. 



Reduction of oxyhiomoglobin defies therapeutical measures 

 if it have advanced beyond the very first stage, that is, the 

 treatment of poisoning by carbonic oxide, prussic acid, etc., is 

 rarely successful. It must, however, be attempted. Combined 



